摘要
目的:总结尿道下裂围手术期操作要点,探讨防控手术并发症的措施。方法:选取2013年1月-2017年12月收治的156例尿道下裂患者为研究对象,通过术中人工诱发勃起评估阴茎弯曲以及尿道板发育情况,明确手术方案(Ⅰ期或分期手术),手术方案的基础为基于尿道板的尿道重建技术。结果:156例患者中,行Ⅰ期手术者123例,分期手术33例;首次就诊患者中,行Ⅰ期手术者67例,分期手术者28例;二次就诊患者中,行Ⅰ期手术者56例,分期手术者5例。中度弯曲患者者行阴茎背侧折叠矫正弯曲21例,重度弯曲患者者均行阴茎背侧折叠矫正术。术后随访6个月~1年,发生尿瘘者11例(发生率7.1%),发生尿道狭窄者14例(8.9%),其中吻合口狭窄者6例(42.9%),尿道外口狭窄者8例(57.1%);术后伴有阴茎下曲者16例(10.3%),阴茎弯曲均小于15°。结论:综合评估尿道下裂类型以及阴茎发育情况,选择合理的术式,掌握术中操作要点,有效提高尿道下裂手术成功率。
Objective:To summarize the operative key points of hypospadias in perioperative period and discuss the precautions for prevention and control of surgical complications.Methods:A total of 156 patients with hypospadias admitted to our urology department from January 2013 to December 2017 were selected as research objects.During the operation,penile bending and urethral plate development were assessed by artificially induced erection,and stage I or stage I operations were performed.The surgical plan was based on urethral plate-based urethral reconstruction technology.Results:There were 123 cases of 156 patients undergoing one stage operation and 33 cases undergoing stage operation.Sixty-seven patients underwent one stage operation and 28 patients underwent stage operation for the first time.Fifty-six patients underwent one stage operation and five patients underwent staging operation.Twenty-one cases of moderate curvature received dorsal penile fold correction,and all cases of severe curvature received dorsal penile fold correction.During the postoperative follow-up period of 6 months to 1 year,there were 11 cases of urinary fistula(7.1%)and 14 cases of urethral stricture(8.9%)[including 6 cases of anastomotic stricture(42.9%)and 8 cases of external urethral stricture(57.1%)].Sixteen cases(10.3%)were accompanied by downward curvature of the penis,and the degree of penile bending was less than 15°.Conclusion:To evaluate the types of hypospadias and the development of penis comprehensively,choose reasonable operation methods,and master the key points of operation can effectively improve the success rate of hypospadias.
作者
南玉奎
张志强
姚礼忠
朱逸飞
王岩岗
马合苏提
齐飞波
文彬
NAN Yukui;ZHANG Zhiqiang;YAO Lizhong;ZHU Yifei;WANG Yangang;MA Hesuti;QI Feibo;WEN Bin(Department of Urology,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China)
出处
《微创泌尿外科杂志》
2020年第4期277-280,共4页
Journal of Minimally Invasive Urology
关键词
尿道下裂
术中评估
并发症
hypospadias
intraoperative evaluation
complications
